Health Update: Pro-inflammatory Diet May Worsen Arthritis and Pain
Mark Smith • April 29, 2024
Hello everyone:
As science progresses, we are learning a lot about how our bodies work. As you know, it is my mantra that inflammation causes, perpetuates, and/or aggravates every known human condition, including how well and how fast or slow we age (yes, I am talking to YOU!). Here is an interesting study about knee arthritis and how an inflammatory diet can be associated with increased pain and a more severe joint destructive trajectory over your lifetime:
“Conclusion: A proinflammatory diet, as indicated by a higher DII score, may be associated with a greater pain score and higher risk of more severe pain trajectory over 10 years. However, inconsistent findings related to structural changes suggest a discordance between the potential impact of diet on structural damage and pain in knee OA.”
https://acrjournals.onlinelibrary.wiley.com/doi/10.1002/acr.25307
Bottom Line:
Consuming a lower or anti-inflammatory diet can have a positive impact on your healthspan, lifespan, aging profile, as well as how fast or slow our joints degenerate. In their paper, they state “that inflammation has emerged as an important factor in the progression and pathology of knee osteoarthritis.”
Additionally, they state that: The DII scores were developed using peer-reviewed articles by assigning a score to each food component that has been found to have robust evidence for its ability to influence systemic inflammation.11, 12 Numerous studies have explored the connections between DII scores and various diseases, revealing that higher scores are linked to increased risks of cardiovascular disease,13 cancer,14 and osteoporosis and fracture.12 High DII scores, associated with higher intakes of food groups including fats, oils, sweets and sodas, meat, fish, poultry, beans and eggs, and lower intakes of whole grains, fruits, and vegetables, are associated with a greater prevalence of radiographic symptomatic KOA and knee pain.15, 16Previous meta-analyses have indicated that high DII components, such as processed meat and sugar, were associated with an increased risk of cardiovascular disease, and higher consumption of red and processed meat, high-salt foods, and alcoholic drinks has been linked to a greater risk of colorectal and stomach cancer.17, 18
If you want to be as healthy as possible, have the best life possible, feel and look your best, then it may be a really great idea to eat a low inflammatory diet. Friends don’t let friends eat that ‘stuff’. Now that you know, what will you do? How will you use this information to guide your lifestyle choices?
Hello again: Because there is such good information on this topic, I felt it urgent enough to share once again with new data for you to consider: “Cardiovascular disease remains the leading cause of death globally and here in the United States. Diet has a major impact on the pathogenesis of atherosclerosis and subsequent cardiovascular morbidity and mortality. An unhealthy diet is the most significant potential behavioral and modifiable risk factor for ischemic heart disease. Despite these established facts, dietary interventions are far less frequent than pharmaceutical and procedural interventions in the management of cardiovascular disease. The beneficial effects of a plant-based diet on cardiovascular morbidity and mortality have been demonstrated in a number of recent clinical studies. Plant-based diets can lower all-cause mortality and lower the risk of ischemic heart disease with reduced IHD-related mortality. It can also optimize blood pressure, glycemic and lipid control, and thus reduce the need for mediations.” https://pmc.ncbi.nlm.nih.gov/articles/PMC9963093/ Bottom Line:
Are Plant-Based Diets Adequate?
Hello everyone: Have you wondered if there is any benefit from going plant-based? Yes, there is and here is some information to assist your choices: “Vegetarian, including vegan, dietary patterns were associated with reduced risk for CVD (cardiovascular disease) incidence and CVD mortality (death) compared to non-vegetarian diets. (Consider the sobering fact that CVD is the number one cause of death worldwide.) Vegan dietary patterns were associated with reductions in CVD risk factors including blood pressure low-density lipoprotein cholesterol (the ‘bad’ cholesterol) and body mass index compared to non-vegetarian dietary patterns, as well as c-reactive protein concentrations (a measure of inflammation!!) in a novel meta-analysis.” Conclusion: Practitioners can consider recommending vegetarian dietary patterns to reduce cardiometabolic risk factors and risk of CVD incidence and mortality. https://pubmed.ncbi.nlm.nih.gov/39430429/ Bottom Line: Here is another good reason to upgrade your food plan. It is certainly worth your while to move towards a Flexitarian type of food plan to protect your health, your future, and help you overcome any current health issues. Flexitarian is what the Mediterranean diet looks like, which I covered in a previous blog. Overall, the data is shifting so strongly to this model that even our USDA has commented that their recommendations are going plant-based due to the overwhelming science supporting its benefits. This approach significantly benefits the environment as well as our health is not separate at all from our planetary health…there is a good reason that our planet is called “Mother Earth” and we should take good care to respect and nourish our planet so that we can be good stewards and healthy as well. One strong step in that direction is to lower our animal-based foods by at least 50% as the research reveals that it will help both human and planetary health significantly. Do some research and see what you find. My bet is that you find this type of food plan is the optimal one, which means lower inflammation and feeling better with a safer future for one and all. The Traditional Mediterranean Diet has been characterized by: 1. Plentiful fruits, vegetables, legumes, grains. 2. Olive oil as the principal fat. 3. Lean red meat consumed only a few times per month or in very small portions. 4. Low to moderate daily consumption of dairy products. 5. Poultry, fish and eggs consumed a couple of times per week; and 6. Moderate consumption of wine. (Low or none is actually best)
Hello again everyone: As you know, I keep promoting a healthy unprocessed whole food plant-based dietary pattern to reduce inflammation and optimize health and longevity. I did not know that beans were so essential till I read this paper! Conclusions : The FHILL (Food Habits In Later Life) longitudinal study shows that a higher legume intake is the most protective dietary predictor of survival amongst the elderly, regardless of their ethnicity. The significance of legumes persisted even after controlling for age at enrolment (in 5-year intervals), gender, and smoking. Legumes have been associated with long-lived food cultures such as the Japanese (soy, tofu, natto, miso), the Swedes (brown beans, peas), and the Mediterranean people (lentils, chickpeas, white beans). https://apjcn.nhri.org.tw/server/APJCN/13/2/217.pdf Bottom Line : For a little more information, consider consuming legumes daily, and it does not take that much to make a difference. Even as little as several tablespoons per day is enough to make a difference. Perhaps it is the vegetable protein, or the resistant starch, or the fiber and gut microbiome effects that cause such a boost in health, but whatever it is, just eat some beans every day. There a quite a few to choose from: Mung beans, chickpeas, lentils, black beans, adzuki beans, red beans, white beans, butter beans, Lupini beans and more…lots of different tastes and textures to add to your plate! One reason that people do not eat beans is due to fear of flatulence! Studies show that this does not affect most of us, and for those that it does the effect will diminish and go away after several weeks of consistently consuming them. So, eat your beans within the context of a great Mediterranean plan! The Traditional Mediterranean Diet has been characterized by: 1. Plentiful fruits, vegetables, legumes, grains. 2. Olive oil as the principal fat. 3. Lean red meat consumed only a few times per month or in very small portions. 4. Low to moderate daily consumption of dairy products. 5. Poultry, fish and eggs consumed a couple of times per week; and 6. Moderate consumption of wine. (Low or none is actually best) PS: As more modern data becomes available, you might see # 3,4, & 5 get smaller as the advantages of vegetarian protein sources are proving superior for longevity and chronic illness and inflammation benefits.
Hello again everyone: As you know, inflammation causes, aggravates, and/or perpetuates all chronic conditions. Another way to say this is that inflammation is the final common pathway of environmental stress…what we eat, what we are exposed to, what we think, and what we do (exercise etc.) can either create health or a lack of health (inflammation). There is a lot of good research that reveals vegetables can reduce inflammation, therefore, going into a whole foods plant-based food plan has many advantages: Conclusions: This study suggests that the previously observed health benefits of cruciferous vegetable consumption may be partly associated with the anti-inflammatory effects of these vegetables. https://pubmed.ncbi.nlm.nih.gov/24630682/ Conclusion : Study results show that the beneficial effects of fruit and vegetable intake on markers of inflammation and oxidative stress are already present by early adolescence and provide support for the Dietary Guidelines for Americans "to consume five or more servings per day" of fruits and vegetables to promote beneficial cardiovascular health. https://pubmed.ncbi.nlm.nih.gov/19248856/ Conclusions: This study suggests that soy food consumption is related to lower circulating levels of IL-6, TNFα, and soluble TNF receptors 1 and 2 (markers of inflammation) in Chinese women. https://pubmed.ncbi.nlm.nih.gov/22889631/ “Epidemiology studies indicate that diet or specific dietary components can reduce the risk for cancer, cardiovascular disease and diabetes. An underlying cause of these diseases is chronic inflammation. Dietary components that are beneficial against disease seem to have multiple mechanisms of action and many also have a common mechanism of reducing inflammation, often via the NFkB pathway. Thus, a plant-based diet can contain many components that reduce inflammation and can reduce the risk for developing all three of these chronic diseases.” https://pubmed.ncbi.nlm.nih.gov/24944766/ Bottom Line: Go whole food plant based. Ditch the sugar, bad fats, additives, preservatives, processing, fried, nutrient deprived food like objects and opt for real food that your biology craves and protect your health. To eat any other way is way too risky.
Hey there everyone: This article helps to clarify the science as it unfolds about lowering your cancer risk with your lifestyle. It now appears that there is enough evidence supporting plant-based food plans for cancer prevention. And although there are multiple mechanisms involved as to how plants reduce cancer risks. ” ...as the evidence accumulates, it increasingly points to one over-arching theme: More plants, less cancer. When it comes to naming the dietary patterns offering the most protection against cancer, plant-based diets emerge as the winner for reducing the risk for several cancers sensitive to lifestyle factors.” https://www.medscape.com/viewarticle/growing-evidence-suggests-plant-based-diets-reduce-cancer-2025a100011d?ecd=mkm_ret_250131_mscpmrk_onc_top-content_etid7196490&uac=428598BV&impID=7196490 Bottom Line: It is important to note the following: “Food Quality Matters : Of course, not all plant-based diets are created equally. It would be easy to fill a diet with French fries, potato chips, and doughnuts and call it plant-based, but no one would mistake that diet for helping to prevent cancer. “It’s important to distinguish between an overall plant-based diet and a healthy plant-based diet,” Giovannucci said. A healthy plant-based diet, for example, positively weights whole grains, fruits, vegetables, vegetable oils, nuts, and legumes, and it negatively weights refined grains, fruit juices, potatoes, sugar-sweetened beverages, and sweets, he explained.” In other words, a diverse Whole Foods Plant Based food plan that avoids ultra-processed foods is crucial to your long-term overall health as well as avoiding cancer. To find out more detailed information about cancer risk and foods, weight, lifestyle activities and more, check out this super informative and easy to use link where you can see the effect size of each item and get details to help your decisions. I spent a good 45 minutes on this link and found out how much science there is about health and plants that I was not aware of: https://www.wcrf.org/research-policy/interactive-cancer-risk-matrix/
Hello again: This article is very important and straightforward, plus it is a really great summary of what low-grade chronic inflammation is all about and how harmful it is…and considering that in the U.S., more than 60% of daily calories by all ages and genders are from UPFs, it is an important and timely topic…so let’s get right into it. “Low-grade inflammation alters the homeostasis of the organism and favors the onset of many chronic diseases. The global growth in the prevalence of noncommunicable diseases in recent years has been accompanied by an increase in the consumption of ultra-processed foods (UPF). Known to be hyperpalatable, economic and ready-to-eat, increased consumption of UPF has already been recognized as a risk factor for several chronic diseases. Current evidence highlights the adverse health effects of UPF characteristics, not only due to the nutrients provided by a diet rich in UPF, but also due to the non-nutritive components present in UPF and the effect they may have on gut health. This review aims to summarize the available evidence on the possible relationship between excessive UPF consumption and modulation of low-grade inflammation, as potential promoters of chronic disease. Inflammation is an immunosurveillance response essential for host defense, which serves to repair damaged tissues and eliminate toxic agents [ 1 ]. However, when this response becomes chronic, it results in the presence of immune system cells for an increasing period of time. This state of low-grade inflammation can lead to dysmetabolic conditions that disrupt homeostasis, favoring the development of a wide range of noncommunicable diseases such as cancer, diabetes and cardiovascular diseases [ 2 ]. Among the environmental and lifestyle factors that can promote or intensify inflammation, increasing scientific evidence supports the role of diet. Potential nutritional compounds influencing inflammation processes include macro- and micronutrients, bioactive molecules such as polyphenols and specific food components [ 19 ]. Overall, plant-based dietary patterns with a high consumption of vegetables, fruits and whole grains, a moderate consumption of legumes and fish and a low consumption of red meat have been associated with a greater anti-inflammatory potential ( Figure 1 ). These include several traditional healthy diets, such as the Mediterranean or the Nordic diet, which are usually based on minimally processed or unprocessed foods [ 20 , 21 ]. A meta-analysis that evaluated a total of 2300 subjects from 17 clinical trials showed that greater adherence to the Mediterranean diet was associated with lower levels of inflammatory biomarkers, particularly CRP and interleukin-6 (IL-6) [ 22 ]. These findings were confirmed in a recent meta-analysis assessing the effect of multiple dietary patterns on inflammatory biomarkers [ 23 ].” https://pmc.ncbi.nlm.nih.gov/articles/PMC10058108/ Bottom Line: Now it becomes more obvious why I am always saying inflammation will cause, perpetuate, and/or aggravate chronic illness of ALL types, and please note that this includes aging. It also becomes apparent as to why a plant-based, whole-food, minimally processed food plan is the best way to go. I urge you to read or review this paper and it will hopefully raise your motivation to fully dedicate yourself, and those you care about, to consume an optimal dietary lifestyle. What you eat will determine to a large extent on how long you live a healthy life (healthspan) as well as how long you live. In the article, there are several good charts (Figure 1 & 2) and information on what UPFs are and the chemicals and toxins in them, so check Section 3 & 4 when you get a chance. It is this kind of information that helps us make informed decisions that can dramatically improve our health and lower our risk for diseases (prevention) as well as promote recovery and resilience if we do become ill. Please, avoid UPFs for your health’s sake and eat foods that love you back!
Hello again everyone: We commonly think about cancer as a genetic disease, and while some are mostly genetically based, most are actually a combination of multiple factors…and one of the clearly identified drivers of cancer happens to be food choices. In this recent study, the following points summarize their findings: “More than 1 in 5 of new gastrointestinal (GI) cancer cases globally were attributable to suboptimal dietary intake, according to a recent study. Writing in Gastroenterology, researchers…reported that excessive consumption of processed meats (the biggest culprit), insufficient fruit intake, and insufficient whole grain intake were the leading dietary risk factors. In addition, the number of diet-related cases doubled from 1990 to 2018. The study also: “…observed that two regional groups, Central and Eastern Europe, Central Asia, Latin America, and the Caribbean, as well as high-income countries, bore the top three diet-attributable burdens worldwide in 2018, all driven mostly by an upward-trending excess of processed meat.” “As for the impact of the SDI (Socio-Demographic Index), the authors explained that diet-attributable GI cancer burden was higher among adults with higher education and living in urban areas than among those with lower education and rural residency. “Some dietary habits tended to be worse in higher-SDI countries, specifically, higher consumption of processed meats,” they wrote. https://www.medscape.com/viewarticle/suboptimal-diets-tied-global-doubling-gi-cancer-cases-public-2025a100026y?ecd=WNL_mdpls_250131_mscpedit_gast_etid7197796&uac=428598BV&spon=20&impID=7197796 https://www.gastrojournal.org/article/S0016-5085(24)05212-0/abstract Bottom Line: Proposed mechanisms for this cancer link were multiple including gut microbiome changes associated with processed meats and other processed foods, a lack of fiber and phytonutrients known to be protective. To reduce your risk, increase your whole-foods, plant based, unprocessed foods and reduce processed meats of any kind. If you choose to eat any other types of animal products, please make sure that they are organic, unprocessed, and constitute about 10% of your daily calories. Current flexitarian guidelines consider that to mean you would consume animal-based products 2 to 4 x per week…but just reducing by 50% is enough to make a real and significant difference in your health as well as that of the planet according to the EAT Lancet Commission. More specifically, the EAT Commission recommends 3 to 26 ounces of meat, poultry, and eggs per week and dairy at about 8 to 17 ounces per day. To read more about this important topic look at this link: https://foodinsight.org/eat-lancet-commission-study-diet-sustainable-red-meat/ You certainly need to figure out what works for you; however, you need to know that there is a burgeoning health based scientific foundation for recommending lowering animal-based food products in favor of an unprocessed, whole-foods plant-based lifestyle. Please refer to my 3/10/25 blog for more exact details and references. What you eat is the primary driver of all of your biochemistry…you can eat to create illness or health…it is your choice. I hope this info helps you make informed decisions.
Hello again, everyone: As you know, I am always looking for foundational lifestyle upgrades that advantage us to lower our inflammatory burden and promote a longer healthspan and lifespan. Because we are all born with genetic ‘clocks’ that coordinate and control all of our biochemical functions, having lifestyle activities (such as when we eat) that align with our clocks turns out to boost health significantly. Here are the main takeaways: “Research from animal models suggested that aligning food intake with rhythms could enhance metabolic efficiency and improve health outcomes,” Ruiz explained. “We wanted to investigate whether these findings translate to humans and how the timing of the eating window — early, late, or self-selected — affects weight loss, fat distribution, and cardiometabolic health in men and women with overweight or obesity,” he said. All participants were randomly assigned to one of four time-restricted fasting groups: early fasting (food consumed between a median of 9:45 a.m.-5:30 p.m.), late fasting (food consumed between a median of 2:20 p.m.-9:30 p.m.), self-selected fasting, or treatment as usual. Study participants also received nutrition education on the Mediterranean diet and healthy lifestyles. “The greater reduction in abdominal subcutaneous fat observed in the early fasting group highlights the potential metabolic advantages of aligning food intake with the body’s natural circadian rhythms. This finding suggests that early time-restricted eating could be particularly beneficial for improving fat distribution and reducing obesity-related risks.” — Jonatan R. Ruiz, PhD https://www.medicalnewstoday.com/articles/intermittent-fasting-earlier-day-help-reduce-more-abdominal-fat-blood-sugar?slot_pos=article_2&utm_source=Sailthru%20Email&utm_medium=Email&utm_campaign=MNT%20Daily%20News&utm_content=2025-01-24&apid=41304130&rvid=a32216b5e1c0c5df3c84080e2b2e161318206dbce6fd663dd747aa557a4753cd#Early-fasting-reduces-amount-of-abdominal-fat Bottom Line: This is a good study for several reasons: · They compared 4 types of food timing. · They instructed people on improved food choices and lifestyle activities. · They found that all types of time restricted eating worked, but early feeding worked the best. · Loss of body fat and improved cardiometabolic health will equate with lowered body inflammation. · Early eating is easy to do, costs nothing, and works the best. Early fasting (described above) probably worked best because it is the only one that aligned with our natural circadian clock rhythms. While it is the best one and the one that I most highly recommend, sometimes jobs or other life situations will not allow early fasting. This paper showed that all types of time restricted eating are beneficial, but the early eating approach had the best results. There are lots of people that do not have any appetite in the morning, and unfortunately, that is problematic as it distorts your biology and can have serious health implications as it will allow the continuation of a large inflammatory burden among other issues. There are a couple of fixes for that: 1. Start a late fasting protocol…once you have that down, try #2. 2. To re-align your circadian clocks, you will need to start eating some kind of breakfast. If you have ANY chronic health issue and do not eat breakfast, it means your circadian clocks need to be reset. To do this, one way to get your clocks aligned and improve your health is to have your regular dinner but only eat half of it and have the other half for breakfast. This works better than you might think. The long-term goal for successful early fasting is to: a. Have a breakfast. b. Consume 80% of your total caloric intake before 2 PM. c. Dinner is the lightest meal of the day, typically 20% or less of your daily food and caloric intake. Give yourself 3 to 6 weeks to get used to this. d. Consume all of your food/calories within a 10-hour window and have 14 hours per day without any calories but stay well hydrated. e. Shift your food choices to an unprocessed, whole-foods plant-based plan where 10% or less of your calories come from animal sources. This is the plan that I follow and highly recommend as it is where I see people make the greatest health improvements. When you eat and what you eat are foundational. In other words, nutrition is the priority simply because the nutrition that you get from your food is what determines your biochemistry, which is what determines how each and every cell functions (physiology), which is what is the main determinant or consequence of how sick or healthy you will be…now and in your future. Because most of us are lifelong learners in different fields, my goal is to pass along what I am learning that has truly foundational and long-term application and importance for all of us. That is why I write these blogs…to pass along this vital information. Our bodies are miraculous Temples so we should honor and treat them as such, and we all can learn how to do this better and better as part of our shared responsibility. Thanks for reading this and all the best to you and yours.
